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Lakeside Healthcare at Stamford Inadequate

Reports


Inspection carried out on 8 June 2021

During a routine inspection

We carried out an announced inspection at Lakeside Healthcare at Stamford on 7 and 8 June 2021. Overall, the practice is rated as inadequate.

The ratings for each key question are:

Safe - Inadequate

Effective – Inadequate

Caring – Requires improvement

Responsive - Inadequate

Well-led - Inadequate

Following our previous focused follow-up inspection on 22 August 2019 the practice was rated as good for providing safe services. This inspection was completed as a desktop review, carried out to assess where the practice had improved in the key question of ‘safe’ and to ensure that they had made the recommended improvements identified during our comprehensive inspection in November 2018. Following the desktop review, the practice was rated as good overall and for all key questions and population groups.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Lakeside Healthcare at Stamford on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a comprehensive review of information undertaking a site visit inspection to follow up on:

  • Key questions inspected.
  • Areas followed up including ‘shoulds’ identified in previous inspection.
  • Any other areas reviewed.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing remote clinical searches on the practice’s patient records system and discussing findings with the provider.
  • Reviewing patient records remotely to identify issues and clarify actions taken by the provider.
  • Requesting evidence to be submitted to us electronically from the provider.
  • To ensure we gathered staff feedback we used a questionnaire which was given to staff electronically via email. To ensure we gathered patient feedback we worked with Healthwatch Lincolnshire who carried out a patient survey on our behalf.
  • A short site visit.

Our findings

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We have rated this practice as inadequate overall and inadequate for all population groups.

We found that:

  • The practice was not providing care in a way that kept patients safe and protected them from avoidable harm.
  • Patients were not always receiving effective care and treatment that met their needs.
  • Staff mostly dealt with patients with kindness and respect and involved them in decisions about their care. However patients commented that their care had been impacted upon by poor access to appointments.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. However, patients were unable to access care and treatment in a timely way.
  • The way the practice was being led and managed did not promote the delivery of high-quality, person-centred care.

We found three breaches of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
  • Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, supervision and appraisal necessary to enable them to carry out the duties.

In addition the provider should:

  • Implement the new telephone system with adequate staff resourcing to improve telephone access for patients.
  • Develop the practice website to include more information on local services and practice updates.
  • Improve visibility and communication between the central support function personnel in Corby Northamptonshire and the practice team.
  • Provide stronger local management by recruiting an appropriately skilled practice or business manager.
  • Develop staff engagement processes, and improve responses to patient feedback to enhance service user experience.

Following our inspection in June 2021, the CQC took urgent action to impose conditions on the provider’s registration to keep patients safe.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration. Special measures will give people who use the service the reassurance that the care they get should improve.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Review carried out on 29 February 2020

During an annual regulatory review

We reviewed the information available to us about Lakeside Healthcare at Stamford on 29 February 2020. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Lakeside Healthcare in Stamford on 28 November 2018.

The overall rating was Good. Safe was rated as Requires Improvement. Effective, Caring, Responsive and Well-led as rated as Good. Population Groups were rated as Good.

The full comprehensive report for the November 2018 inspection can be found by selecting the ‘all reports’ link for Lakeside Healthcare at Stamford on the CQC website – .

This inspection was a focussed follow-up inspection which was completed as a desktop review carried out on 22 August 2019. It was undertaken to assess where the practice had improved in the key question of ‘Safe’ and made the recommended improvements identified during our previous inspection in November 2018. The report covers our findings to those requirements and additional improvements made since the last inspection.

The practice overall rating remains as Good. The practice is now rated as Good for providing Safe Services.

Our key findings were as follows:

  • Care and Treatment was provided in a safe way for service users.
  • Appropriate recruitments systems and processes were in place
  • The practice now had a clinical oversight model in place to ensure staff had the appropriate qualifications and skills to provide safe patient care.
  • Improvements to the security of the dispensary had been put in place.

The areas where the provider should make improvements are:

  • Have oversight of legionella water temperature monitoring carried out by external contractors at both sites and ensure actions are taken when required.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Inspection carried out on 28 November to 28 November 2018

During a routine inspection

We carried out an announced comprehensive inspection at Lakeside Healthcare Stamford on 28 November 2018 as part of our inspection programme. We inspected both sites at Sheepmarket Surgery and St Mary’s Medical Centre. Both sites had been inspected previously and had been rated good overall. We inspected St Marys Medical Centre as part of our inspection programme in June 2017. Sheepmarket Surgery was inspected in February 2015 and rated requires improvement overall. We carried out follow up inspections in April and September 2017 to check improvements had been made and as a result, the practice was rated as good overall.

We based our judgement of the quality of care at this service on a combination of:

  • what we found when we inspected
  • information from our ongoing monitoring of data about services
  • information from the provider, patients, the public and other organisations and
  • patient interviews with Healthwatch.

We have rated this practice as good overall and for all population groups.

We found that:

  • There was an effective system for high risk drug monitoring.
  • Performance data was in line with local and national averages.
  • We saw evidence of systems and processes for learning, continuous improvement and innovation.
  • Although the practice had clear processes for managing risks, these were not always followed through and actioned.
  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs and patients we spoke with told us they were treated with kindness and compassion.
  • We saw staff dealt with patients respectfully and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

Whilst we found no breaches of regulations, the provider should:

  • Audit nurse prescribing and implement a system to provide oversight of nurses working in the same day clinics.


Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice